How it works

Indomethacin helps relieve pain and inflammation by blocking the effects of the enzymes cyclooxygenase (COX)-1 and COX-2. This prevents prostaglandin synthesis (prostaglandins elevate body temperature and make nerve endings more sensitive to pain transmission).

Indomethacin belongs to a group of medicines known as NSAIDs (nonsteroidal anti-inflammatory drugs).

NSAIDs (including indomethacin) are considered first-line options for mild-to-moderate acute pain because at correct dosages they are effective, do not cause dependence and are readily available at a low cost.

Available as immediate-release capsules and suspension, extended-release capsules, and as a suppository.

Generic indomethacin is available.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

Indigestion, heartburn, and very occasionally, stomach ulceration and bleeding. People of an older age, taking other medicines that affect the stomach, or who drink more than 3 glasses of alcohol per day may be more at risk. People of an older age, taking other medicines that affect the stomach, or who drink more than 3 glasses of alcohol per day may be more at risk. Indomethacin is considered to carry a high risk for stomach-related side effects compared with other NSAIDs.

A headache is also a common side effect. Other side effects include tinnitus (continuous ringing or buzzing in the ears), constipation, and difficulty concentrating.

Indomethacin is one of the most potent NSAIDs and is generally only used after other NSAIDs have proved ineffective.

NSAIDs (including indomethacin) have been associated with an increased risk of stroke or heart attack. The risk may be higher in patients with pre-existing cardiovascular conditions and with higher dosages. Indomethacin is considered to carry a high risk for cardiovascular-related side effects compared with other NSAIDs.

Oral and rectal preparations are not available over-the-counter (have to be prescribed).

May not be suitable for some people including those with kidney disease, a history of stomach ulcers or other gastrointestinal disorders, with pre-existing cardiovascular disease, or following coronary artery bypass graft surgery. Should not be used by children aged less than 14 years and during pregnancy.

May interact with some other medicines such as warfarin, SSRIs, ACE inhibitors, and diuretics.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Indomethacin relieves inflammation and pain associated with various types of arthritis. The risk of stomach-related and cardiovascular side effects may be higher with indomethacin than that seen with other NSAIDs such as ibuprofen.

Tips

Take with food to reduce stomach-related adverse effects.

Always use the lowest effective dose for the shortest duration consistent with the condition being treated.

Response to different NSAIDs can vary so switching types (for example, from indomethacin to naproxen) may improve response.

Talk to your doctor if you experience any abdominal pain after taking indomethacin, particularly if the pain persists.

NSAIDs such as indomethacin should not be used in the last 3 months of pregnancy; ask your doctor before using any medication during pregnancy.

Do not take NSAIDs such as indomethacin or aspirin if you have experienced asthma or hives due to NSAID use in the past.

If you are taking indomethacin and find it is not working very well for you, you may like to try a different NSAID.

Do not use this medicine immediately following heart bypass surgery (coronary artery bypass graft, or CABG).

See a doctor immediately if you experience any difficulty with breathing, unexplained sickness or fatigue, loss of appetite, vision changes, fluid retention or abnormal bleeding.

Response and Effectiveness

Peak levels are reached 2 hours after administration, and 90% of a dose is absorbed within 4 hours of administration.

Professional resources

Related treatment guides

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use indomethacin only for the indication prescribed.

Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of this information. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.